Objective To evaluate the methods of diagnosis and treatment of thyroid disease with concomitant focal lymphocytic thyroiditis(FLT), and explore the reasons for its confused with Hashimoto′s disease(HD).Methods During the recent 25 years, 207 patients underwent surgical trearment for pathologically diagnosed HD.Among this group, 143 cases of HD with other concomitant thyroid disease were retrospectively analysed.Results Of the 143 cases, 57 cases were found to have thyroid disease with concomitant FLT, and this was 27.5%(57/207) of the total HD group, or 39.9%(57/143) of the group with thyroid disease and concomitant HD.Intraoperative pathologic section revealed that focal lymphocytic infiltration was positive in 87.7%(50/57) of cases. The postoperative hypothyroidism occurrence rate was 19.3%(11/57), of which, 7 cases(7/57, 12.3%) were subclinical hypothyroidism.Conclusions The character of pathologic changes of thyroid disease with FLT and with HD was different. Intraoperative pathologic section can be helpful in the diagnosis of this condition and can have important significance as a guide to the scope of (surgical) resection of the thyroid gland.

Objective To explore the features of high-frequency ultrasonography and contrast-enhanced ultrasonography (CEUS) of papillary thyroid microcarcinoma (PTMC).Methods The CEUS data and ultrasound data of 147 PTMCS which were reconfirmed by pathology were analyzed retrospectively,and the CEUS and ultrasonic characteristics of them were summarized.Results Among 147 nodules,144 (97.9％) nodules were hypoechoic,and 3 nodules were isoechoic.Vague edge was found in 136(92.5％) PTMCs,and 126(85.7％) PTMCs were irregular in shape.Totally 92(62.6％) PTMCs were A/T ＞ 1,microcalcifications were found in 81 (55.1％) PTMCs.Besides,26(74.2％) PTMCs were found microcalcification in 35 PTMCs combined with Hashimoto's thyroiditis (HT),while 55 (49.1％) PTMCs were found microcalcification in 112 PTMCs combined with HT.There were significant differences between them (P ＜ 0.05).The blood distribution of 129 (87.8％) nodules was type Ⅱ.The contrast-enhanced pattern of 147 (100.0％) PTMCs showed in-homogeneous enhancement in 144 (97.9％) nodules,hypoenhancement in 136(92.5％) nodules,and all the nodules without amicula.Conclusions The typical PTMCs are hypoechoic,irregular shapeand vague edge,usually were found as A/T ＞ 1,microcalcification,and type Ⅱ blood distribution.With the method of contrast-enhanced ultrasonography,these nodules usually without amicula showed inhomogeneous and hypoenhancement.The incidence of microcalcification is more common when patients with Hashimoto's disease coexisting PTMC.

Objective To evaluate the relationship between the clinicopathological factors, prognosis and the expression of p16 and c erbB 2 protein in primary breast cancer. Methods The expression of p16 and c erbB 2 by immunohistochemical method was observed in 50 patients with primary breast cancer and the detection of p16 by polymerase chain reaction(PCR) and the point mutation of p16 by PCR single strand conformational polymorphism(SSCP) were detected in 20 patients with breast cancer. Results Among the cancers, positive expression of p16 protein was found in 17(34.00%) cases, c erbB 2 protein positive expression in 24(48.00%) cases. No homozygous deletion in p16 gene was found. However, exon2 point mutation of p16 gene was found in 1 of 20 breast cancer. The results showed no relationship between p16 expression and clinicopathological factor or prognosis. Positive expressions of c erbB 2 protein were often found in breast cancer with lymph node metastasis(P=0.0237) with a poor 5 year survivalrate(P=0.0169). There was no consistent relationship between the expression of p16 and c erbB 2 protein. Neither p16 nor c erbB 2 protein expression could be as an independent prognostic factor. Conclusions The patients with breast cancer of positive expression of c erbB 2 protein has a high lymph node metastasis rate and a poor survival rate. The point mutation rate of p16 gene is lower in primary breast cancer, and it can be a molecular events in advanced primary breast cancer.

Objective To investigate the natural course and treatment of adult liver hemangioma (ALH).Methods The records of ultrasonography of 2422 patients with ALH were retrospectively reviewed.Results The patients were between 16 and 69 years of age (mean age 42,9± 11.4) with a male to female ratio of 1 ∶ 1.02 (1197/1225).The prevalence rate gradually increased with age after 30 years old.The highest prevalence rate occurred between 40-69 years.ALH was most commonly 1.1-3 cm in size,located in right liver with a solitary lesion.ALHs were bigger and were seen earlier in females than males.Concurrent illness was also more common in females than males.1427 patients had 3 to 8 repeat sonographies.At a follow-up of 42.7±9.5 months,1351 patients had no change in the ultrasonographic pattern or number of haemangiomas.Increasing in size of the lesions was demonstrated in 76 patients.154 patients received operation or interventional treatment.Conclusions The prevalence rate of ALH rose with age.Female sex hormones might accelerate ALH enlargement but they did not induce the formation of ALH.Most ALH remained stable in size and in patterns.Attention should be paid to rule out other illnesses in patients with ALH and with symptoms.

Objective: To explore the value of different designed anterolateral thigh flaps(ALT) in the reconstruction of buccal defect after radical resection of buccal cancer. Methods: From March 2009 to May 2016, 142 cases were diagnosed as buccal cancer in the Department of Oral and Maxillofacial Surgery of Nanjing University. All patient underwent radical resection, followed by reconstruction with different anterolateral thigh flaps. The clinical date were retrospectively analyzed. Results: Among 142 cases, the muscuiocutaneous ALT flaps were used in 60 cases, the fasciocutaneous ALT flaps in 60, and the thin ALT flaps in 22. The size of the flaps ranged from 4 cm×5 cm to 14 cm×10 cm. Operative exploration during the perioperative period were performed in 4 patients, including 2 flaps with thrombotic events and 2 flaps with venous thrombosis. Among them, 2 flaps survived completely and 2 flaps were failure. The mean follow-up period was 37 months(range: 3 to 85 months). Conclusions The different designed anterolateral thigh flap for the buccal defects resulting from tumour excision is an ideal choice for reconstruction of buccal defects.

Objective To investigate the clinical value of lung ultrasound (LUS) in the diagnosis of infectious pneumonia in premature infant.Methods 20 premature infants with infective pneumonia were selected and examined by high-frequency ultrasound.The results were compared with chest X-ray data.Pulmonary ultrasound was monitored on the 3rd to 5th,8th to 10th days of treatment and before discharge.The total number and maximum depth of pulmonary consolidation were calculated and the changes of the above parameters with the progression of pulmonary diseases were compared.Results The LUS imaging of 20 cases showed:A-line disappearance and pulmonary interstitial syndrome (100％),lung consolidation (95％),abnormal pleural lines (55％),interstitial syndrome (100％) and pleural effusion (15％).The X-ray of 20 cases showed:increased lung texture(100％),patchy blurred glass shadow (40％),lung consolidation(40％).The maximum depth of lung consolidation and the total number of lung consolidation involving rib clearance are decreased after therapy.Conclusions LUS is of great value in diagnosis and monitor the progresses of infectious pneumonia in premature infant,and can be used as the preferred diagnostic method in imaging.

Objective:To explore the value of Plan-Do-Check-Act (PDCA) management model in improving the quality of breast ultrasound diagnosis.Methods:From January 1 to December 31, 2021, patients undergoing breast nodule surgery in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were selected for breast ultrasound Breast Imaging Reporting and Data System (BI-RADS) classification diagnosis and follow-up. Using pathological results as the gold standard, the malignant rate of different BI-RADS grade and the coincidence rate of ultrasound diagnosis of breast cancer before the first treatment were analyzed. PDCA cycle management mode was introduced to analyze, learn and sort out the quality of breast ultrasound diagnosis. The same method was used to follow up the breast ultrasound diagnosis in the ultrasound department of our hospital from January 1 to December 31, 2022. The results of two follow-up visits were compared.Results:Compared with 2021, the malignancy rates of category 3 and 4a BI-RADS diagnosed by ultrasonic diagnosis of breast nodules in hospitals in 2022 were closer to the malignancy rates recommended by the classification guidelines of BI-RADS (all P<0.05). There was no significant difference in the malignant rate of BI RADS 4b, 4c and 5 types of nodules (all P>0.05). In 2022, compared with 2021, the ultrasound diagnosis coincidence rate before the first treatment of breast disease increased from 90.4%(1 592/1 761) to 95.9%(1 806/1 884). Conclusions:PDCA management mode is helpful to improve the classification and diagnosis quality of breast ultrasound BI-RADS, and better assist clinical diagnosis and treatment.

Purpose To explore the value of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of gallbladder polypoid lesions(GPLs)(diameter≥10 mm).Materials and Methods A prospective enrollment of 229 patients with GPLs who underwent cholecystectomy in 17 hospitals from December 1 2021 to June 30 2024 was conducted to analyze the relationship between general data,conventional ultrasound,CEUS characteristics and the nature of GPLs.Multivariate Logistic regression was employed to identify independent risk factors for neoplastic polyps,the differential diagnostic value of different indicators was compared.Results Among 229 patients with GPLs,there were 108 cases of cholesterol polyps,102 cases of adenoma and 19 cases of gallbladder cancer.Age(Z=-4.476,P<0.001),polyp number(χ2=15.561,P<0.001),diameter(Z=-8.149,P<0.001),echogenicity(χ2=9.241,P=0.010),vascularity(χ2=23.107,P<0.001),enhancement intensity(χ2=47.610,P<0.001),enhancement pattern(χ2=6.468,P=0.011),vascular type(χ2=84.470,P<0.001),integrity of gallbladder wall(χ2=7.662,P=0.006)and stalk width(Z=-9.831,P<0.001)between cholesterol polyps and neoplastic polyps were statistically significant.Age,location,diameter,echogenicity,enhancement pattern,vascular type and stalk width between adenoma and gallbladder cancer were statistically significant(Z=-4.333,-3.902,-5.042,all P<0.05).Multivariate Logistic regression analysis showed that hyper-enhancement,branched vascular type and stalk width were independent risk factors for neoplastic polyps(OR=4.563,5.770,3.075,all P<0.001).The combination of independent risk factors was better than single factor and diameter in the differential diagnosis of cholesterol polyps and neoplastic polyps(all P<0.01).Conclusion CEUS can effectively identify the nature of GPLs and provide a valuable imaging reference for the selection of treatment methods.

Long-term primary culture of mammalian cells has been always difficult due to unavoidable senescence. Conventional methods for generating immortalized cell lines usually require manipulation of genome which leads to change of important biological and genetic characteristics. Recently, conditional reprogramming (CR) emerges as a novel next generation tool for long-term culture of primary epithelium cells derived from almost all origins without alteration of genetic background of primary cells. CR co-cultures primary cells with inactivated mouse 3T3-J2 fibroblasts in the presence of RHO-related protein kinase (ROCK) inhibitor Y-27632, enabling primary cells to acquire stem-like characteristics while retain their ability to fully differentiate. With only a few years' development, CR shows broad prospects in applications in varied areas including disease modeling, regenerative medicine, drug evaluation, drug discovery as well as precision medicine. This review is thus to comprehensively summarize and assess current progress in understanding mechanism of CR and its wide applications, highlighting the value of CR in both basic and translational researches and discussing the challenges faced with CR.

Approximately 140 million people worldwide are homozygous carriers of APOE4 (ε4), a strong genetic risk factor for late onset familial and sporadic Alzheimer's disease (AD), 91% of whom will develop AD at earlier age than heterozygous carriers and noncarriers. Susceptibility to AD could be reduced by targeted editing of APOE4, but a technical basis for controlling the off-target effects of base editors is necessary to develop low-risk personalized gene therapies. Here, we first screened eight cytosine base editor variants at four injection stages (from 1- to 8-cell stage), and found that FNLS-YE1 variant in 8-cell embryos achieved the comparable base conversion rate (up to 100%) with the lowest bystander effects. In particular, 80% of AD-susceptible ε4 allele copies were converted to the AD-neutral ε3 allele in human ε4-carrying embryos. Stringent control measures combined with targeted deep sequencing, whole genome sequencing, and RNA sequencing showed no DNA or RNA off-target events in FNLS-YE1-treated human embryos or their derived stem cells. Furthermore, base editing with FNLS-YE1 showed no effects on embryo development to the blastocyst stage. Finally, we also demonstrated FNLS-YE1 could introduce known protective variants in human embryos to potentially reduce human susceptivity to systemic lupus erythematosus and familial hypercholesterolemia. Our study therefore suggests that base editing with FNLS-YE1 can efficiently and safely introduce known preventive variants in 8-cell human embryos, a potential approach for reducing human susceptibility to AD or other genetic diseases.
Humans ; Apolipoprotein E4/genetics* ; Cytosine ; Mutation ; Blastocyst ; Heterozygote ; Gene Editing ; CRISPR-Cas Systems